Nursing 202: Quiz #5 Social Determinants of Aging

Social Determinants of Health (SDOH) - interrelated, with each variable impacting or affecting others

“The non-medical factors that influence health outcomes. They are conditions in which people are born, grow, live, and age, and the wider set of forces shaping the conditions of daily life” 

Social environment (discrimination, income, education level, marital status), Physical environment (place of residence), Health service (access to care, quality of care, insurance status)

What 3 factors are shaped by larger social and economic systems? 

Socioeconomic and Political Context, Structure Determinant, and Intermediary Determinants

What are the 3 parts of the Commission for Social Determinants?

Socioeconomic and Political Context

Big picture forces that shape way society works. Background setting of our lives.

Structure Determinant

Influence out social position (income, education, gender, social class) - place people in different positions in society (label society puts on you)

Intermediary Determinants

Depending on social position, you will experience different day to day conditions (housing, behaviors, psychological factors). Things you face in your everyday life (ex: behavior - smoking) 

Why some groups are healthier than others and the driving force behind inequities comes from 

Commission for Social Determinants: All these layers together shape whether people enjoy good health and well-being or face health inequities: what do these frameworks help us understand?

40%, 10%, 30%, 20%

Person Diagram: % of Socioeconomic factors, physical environment, health behavior and health care 

80%

Up to what % of our health is shaped by non-medical factors (policy, income, education, housing, and environments) all matter just as much as clinical care 

Social gradient of health

The lower your socioeconomic position, the worse your health tends to be

Social, economic, and environmental conditions that are key to ensuring the health and well being of older adults 

SDOH and Older Adults

20% (leading to an increase in SDOH risk)

By 2030, it is predicted that what % of the nation’s population will be 65 years or older, leading to an increase in SDOH risks 

Access to nutritious food, stable employment, and safe housing all matter for our overall health

SDOH of older adults EXAMPLES

Men: sudden death from acute illness and Women: long term management of chronic conditions 

Gender and Health: Difference between men and women (impact of lifestyle risk factors)

Lower income and education levels are more likely to face healthcare struggles. Cultural factors affect diet and exercise behavior

Race, Ethnicity, and Health: Disparities shaped by social forces influences: living conditions, healthcare access, poverty. Socioeconomic status linked to health indicators including

Women = longer life, more disability whereas Men = shorter life, acute illness (Caregiving roles lead to health & finances)

SDOH Gender and Aging

Lifelong inequities lead to health disparities, structural racism lead to chronic disease, lower life expectancy and cultural values lead to caregiving, diet, aging norms

SDOH Race/Ethnicity and Aging

Intersectionallity

Gender × Race leads to amplified risks. EX: women of color lead to financial insecurity.

Economic and financial stability plays a huge role in if one can live a healthy life

People with disabilities, injuries, or conditions like arthritis don’t earn enough to afford the things they need to stay healthy. Emphasize the importance of employment programs, career counseling, high-quality child care opportunities (policies to help people pay for food, housing, health care, and education)

1 in 10

In the United States, ___ people live in poverty (steady employment leads more likely to be healthy) 

Economic stability for older adults 

Link to Well-Being: Crucial for seniors' overall well-being, economic security needs covers healthcare costs, housing expenses, transportation access, monthly living expenses

22.8% of low-income adults 65+ struggle to pay monthly living expenses 

Economic stability for older adults CHALLENGES

42 million Americans face food insecurity/hunger and seniors often choose between food, rent, medicine

Food Insecurity in the US

1 in 10 (less likely to have a primary care provider, and they may not be able to afford health care services/medications they need

In the US, about ___ people in the US don’t have health insurance.

Navigating complex health systems, understanding treatment plans, following complicated medication schedules, paying for care, accessing services (transportation, availability)

Challenges for Seniors in Health Care

60%

____% of seniors have two chronic conditions.

85%

_____% of older adults suffer from at least one chronic condition

Higher education leads people to be healthier, live longer whereas low-income, disability, discrimination lead to struggle in school

Less graduation/college lead to unsafe, low-paying jobs and more health risks (poverty stress affects brain development) 

Education Access and Quality

College grads live 5+ years longer, higher education lead to better health literacy, older women at risk (limited access), overall disparities shape health & life span

Education Level for Older Adults → Life Expectancy: Education = key social determinant

Risks: violence, unsafe air & water, environmental hazards. Higher risks for racial/ethnic minorities, low-income groups. Workplace exposures: secondhand smoke, loud noise

Neighborhoods affect health & well-being but what are the risks? Policies & community design improve safety (e.g., sidewalks, bike lanes)

Safe and Walkable Environment, Community Support Services, Affordable Housing, Influence of Home and Community, and Challenges of Living Alone

Environment for Older Adults

24, 47, 30, 41

Challenges of Living Alone:

% of older adults concerned about living alone, % of lonely older adults worried about aging alone, % concerned about independent living; % of those living alone express the greatest concern

27%

____ % of U.S. adults age 60+ live alone

Living alone leads to isolation, loneliness, cognitive decline, worse chronic conditions, ↑ mortality risk (1 in 5 older adults frequently or often feel lonely)

Social Connectedness of Older Adults (Low-income older adults face higher loneliness rates)